MECC Credentialing Form
To request assignment to a resourcing level.
Email address *
Please refer to the Amateur Radio Operator Credentialing Requirements and Resource Typing (REVISED 02/08/2018) for all requirements.
Upload copies in .pdf format of all IC course or ARRl course certificates to mecccredentialing@gmail.com
Full Name *
Your answer
CALL SIGN *
Your answer
Current Licensure *
Your answer
Membership Agency including contact person and email address. *
Your answer
Current Level(if assigned) *
Resourcing Level Being Requested *
IS-100 Completion Date *
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DD
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YYYY
IS-700 Completion Date *
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DD
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YYYY
For Level III
Complete the following questions
Date acted as Net Control for amateur radio net
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YYYY
Name and contact information of person who can confirm the information
Your answer
Emcomm Group ID from which agency
Your answer
IS-200 Completion Date
MM
/
DD
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YYYY
IS-800 Completion Date
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DD
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YYYY
For Level II
Complete the following questions
Mode other than voice in which you have proficiency. (Digital, CW, RTTY, etc)
Your answer
Name and contact information of person who can confirm the information
Your answer
Have operating proficiency as Net Control Operator
Name and contact information of person who can confirm the information
Your answer
If required by jurisdiction, do you have a completed background check.
Do you have a jurisdictional issued communications ID.
Completion date of ARRL Course EC-001
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DD
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YYYY
If you have not completed EC-001, then provide the completion dates of the following IS courses:
IS-120 An Introduction to Exercises
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YYYY
IS-235 Emergency Planning
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YYYY
IS-288 The Role of Voluntary Agencies in Emergency Management
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YYYY
IS-130 Exercise Evaluation and Improvement Planning
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YYYY
IS-315 CERT Supplemental Training; The Incident Command System (IS-300 may be substituted)
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DD
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YYYY
For Level I
Complete the following questions;
What leadership position do you hold in an Emcomm Group (include the group name)
Your answer
Describe how you have led and directed radio operators in exercises, public service events or radio training
Your answer
Name and contact information of person who can confirm the information
Your answer
Completeion date of ARRL course EC-016
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DD
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YYYY
If you have not completed EC-016, then provide the completion dates of the following IS courses:
IS-230 Fundamentals of Emergency Management
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YYYY
IS-240 Leadership and Influence
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YYYY
IS-241 Decision Making and Problem Solving
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IS-242 Effective Communications
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YYYY
IS-244 Developing and Managing Volunteers
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YYYY
IS-802 Emergency Support Functions (ESF) #2- Communications
MM
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DD
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YYYY
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